The Vancouver Classification was used to classify periprosthetic fracture.

The MDI score was calculated using radiographs from the uncemented group. As a control
(gold standard), Yeung et al's

Canal Bone Ratio

(CBR) score was also calculated. From this, a receiver operating characteristic (ROC)
curve was formulated for both scores and area under the curve (AUC) compared. Intra
and inter-observer correlations were determined.

Cost analysis was also worked out for adverse outcomes.

Four hundred and seven uncemented and one hundred and fifty-three cemented stems were
implanted. The use of uncemented implants was the main risk factor for intra-operative
periprosthetic fracture.

JRI uncemented hemiarthroplasty has a significantly higher intra-operative fracture
rate. We recommend cemented arthroplasty for hip fractures. We propose a radiographic
system that may allow surgeons to select patients who are good candidates for uncemented
arthroplasty, but it needs prospective validation.